title: Reduced incidence of lower-extremity amputations in a Danish diabetes population from 2000 to 2011.
abstract: OBJECTIVE
  Diabetic foot disease and amputations severely reduce quality of life and have major economic consequences. The aim of this study was to estimate time trends in the incidence of lower-extremity amputations in Danish people with diabetes.
  
  
  METHODS
  We studied major and minor lower-extremity amputations from 2000 to 2011 among 11,332 people with diabetes from the Steno Diabetes Center. Amputations were identified by linkage of the electronic medical system with the National Patient Registry. Sex-specific incidence rates of amputations by age, diabetes duration, calendar time and diabetes type were modelled by Poisson regression.
  
  
  RESULTS
  From 2000 to 2011, 384 incident lower-extremity amputations (205 major, 179 minor) occurred during 100,495 years of patient follow-up. From 2000 to 2011, the incidence of all lower-extremity amputations decreased by 87.5% among men and 47.4% among women with type 1 diabetes and by 83.3% among men and 79.1% among women with type 2 diabetes (P < 0.001). In particular, there was a decline in major lower-extremity amputations. In 2011, the incidence rates of major lower-extremity amputations were 0.25 (95% CI 0.07-0.82) among men and 0.21 (95% CI 0.06-0.71) among women per 1000 patient-years at age 50 years and 0.56 (95% CI 0.18-1.89) among men and 0.41 (95% CI 0.16-1.09) among women per 1000 patient-years at age 70 years. No significant change in incidence of minor amputations was observed.
  
  
  CONCLUSIONS
  The incidence of major lower-extremity amputations reduced significantly from 2000 to 2011 in Danish people with diabetes followed at a diabetes specialist centre.
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark.
authors.forename: M E
authors.initials: ME
authors.lastname: Jørgensen
authors.forename: T P
authors.initials: TP
authors.lastname: Almdal
authors.forename: K
authors.initials: K
authors.lastname: Faerch
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data / Q000639:trends*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012044:Regression Analysis; D012737:Sex Factors